Cryoglobulinemic glomerulonephritis: A membranoproliferative glomerulonephritis induced by hepatitis C virus

摘要: Mixed cryoglobulins (MCs) are proteins that precipitate from cooled serum, and composed of a polyclonal immunoglobulin G (IgG) bound to another acts as an anti-IgG rheumatoid factor (RF). In type II mixed cryoglobulinemia, the antiglobulin component, usually IgM class, is monoclonal; it in III cryoglobulinemia. The majority MCs found patients with connective tissue diseases, infectious or lymphoproliferative disorders, hepatobiliary immunologically mediated glomerular diseases (secondary MCs). etiology not clear for 30% all MCs, this cryoglobulinemia called "essential." There common clinical syndrome types essential (EMC) characterized by purpura, weakness, arthralgia. EMC only, which IgMk monoclonal RF, membranoproliferative glomerulonephritis (MPGN) occurs some peculiar morphologic features; termed "cryoglobulinemic GN." Glomerulonephritis can be differentiated idiopathic MPGN, especially acute stage, nephritic syndrome, following findings: (1) presence large deposits filling capillary lumen sometimes shown have characteristic fibrillar crystalloid structure electron microscopy; (2) extent exudative component consequent frequently massive infiltration monocytes; (3) more diffuse evident thickening basement membrane, has double-contoured appearance mainly due peripheral interposition monocytes, less mesangial expansion; (4) possibly vasculitis small medium-sized renal arteries without concomitant features segmental necrotizing GN crescentic GN.(ABSTRACT TRUNCATED AT 250 WORDS)